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STI Testing, Safer Sex Social How-Tos, Fresh Starts and a Bittervention

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frenchiemathwhiz asks:

Heather: I have a question about STD testing, but it's together with a lot of other stuff, so I'm giving you some of the whole story.

My long-term boyfriend just broke up with me, seemingly out of the blue. We were together for several of the most tumultuous years of our lives—we dealt with so much stuff, I can't even describe it. We lived together, we lived apart, we did long-distance, we came back, we kept going. We stayed together through moves, parents condemning our relationship, changing universities, changing friends, changing careers. I feel really stupid being broken up about it; my personal philosophy has always been: no mourning over guys. Only stupid women do that. (Obviously there's some of my own internalized misogyny in there, but I'm also being practical. A woman mourning a man comes off as pathetic; a man mourning a women is soulful and sad. That's just the way it is.) But I did (bleech, sounds so gross) really trust him. I let him in my, like, inner circle of trust.

He just broke up with me because apparently he HAS to sleep with this other girl, and he couldn't even wait until he was going to see me in a few weeks. He started hanging out with this group of party guys and I kept saying it was changing him. He kept denying it—until it did. He just got his first job and then started freaking out: he started to get into drugs, to do all this stuff.

Heather Corinna replies:

frenchiemathwhiz's question continued:

I was standing by him because I've freaked out about stuff before, and I thought he was there for me. But apparently not.

Anyway, we were each other's first sexual partners—vaginal, oral, etc.

I'm moving to a new city and a new job in a few weeks (something I had planned before all this), and it does seem like a time to make a fresh start. The problem is, almost everyone I might sleep with now is going to have had previous partners, so I'm going to have to make them get tested before hand. But:

1) I hear that most generic STD tests don't test for herpes (and other stuff?) and often it means that herpes can spread because people don't know they have it. What all do I have to make sure is in the STD test I and others take? Is a more-thorough test going to cost more than a less-thorough one?

2) I'm not kidding myself that I'm going to be able to have a committed relationship again; I'm young, and all you hear in the news and on the blogs is hook-up culture, all men won't do relationships, etc. I didn't believe it because it seemed really weird—actually all my friends are in long-term relationships in this culture where everyone talks as if no one does relationships. But now I can see that obviously it is true. So, I can't expect a man to necessarily tell the truth about the STD test; I'm going to need some proof. Is there a card of good-health or something the places give you?

3) How do you get people to take STD test for you anyway? I mean I can do it; I can put on my face and laugh and just out-blunt anyone so I don't get hurt. I don't know.

I always love your in-depth answers. Thanks so much.

Before anything else, I want to address how you're feeling, since it sounds to me like the most important, biggest stuff you brought to the table today. It's also what you're actually dealing with right now.

I assume you wouldn't have told me the whole story if you didn't want me to address it, but if I'm wrong in that, I apologize for unsolicited advice. Perhaps obviously, just like any advice or answers I'd give you, including about questions you've asked directly, you're certainly welcome to take it or leave it.

I want to offer you a Bittervention.

It sounds like you were put through the mill with this relationship, recently, but also throughout. It sounds like you suffered a truly painful betrayal, and the kind where it was also paired with feeling like a really, really stupid, meaningless thing to have a relationship finally get tanked by. In my experience, big betrayals that occur because of someone doing something that seems so utterly small and meaningless in comparison to what they're choosing to screw up make them feel so much worse.

I hear what sounds like trying to coach or push yourself into being very cavalier or hard about something you actually feel pretty deeply hurt by, and very sad and vulnerable -- and probably also very angry -- about. You bring up internalized misogyny playing a part in some of this, and I can see that, save that it doesn't sound very internal right now: it's looking pretty darn externalized to me. I have to tell you, I'm also not buying the toughness you're putting out here. I suspect you're instead feeling really fragile and broken.

I can only assume you were in that long-term relationship, and as invested in it as much as you clearly were, because you cared a great deal about your ex. I can only assume you tried to stick it out through very hard parts, even when you suspected things were going seriously south, because this person wasn't just "guys," he wasn't just "a man," but he was a whole person, not just some random member of a group made of billions of people, and a serious big-time love for you.

The loss of something like that? An experience like that? It's going to knock anyone with a pulse to the ground face-first and leave them choking on their heart. It is going to shake our world up immensely. I am so very sorry this all happened to you, and I'm so sorry that you not only lost something it sounds like you put a lot of time, heart and care into building, but lost it in such a craptastic way, no less. I don't think there's anything gross about trusting people or opening our hearts to people. I'm guessing you are feeling gross about it now because that trust was so betrayed, and the love you gave and built sounds like it was really devalued. From the sounds of things, it also sounds like this breakup and how it happened wasn't the first nail in the coffin, but the last, and like you've been carrying around some hard feelings and war wounds for a while now.

Mourning that kind of a loss, and grieving not only isn't pathetic -- and I disagree with you about the idea that only one gender gets to mourn a loss like this acceptably, and another is somehow pathetic and stupid -- it's a process you need to go through, and without closing yourself off to any of it, or trying to be tougher than you feel, in order to deal with and heal from that loss and come out the other side without becoming a bitter person you don't want to have to live with, someone I'm highly doubting you really are.

I get it, that kind of posturing, even by yourself, to try and keep it together and to try and save face. I know all too well how that goes, both from seeing loads of other people do it, and even from doing it myself before. Plenty of us have done it, no matter our gender or the situation. It can be really freaky scary to feel wrecked, vulnerable, humiliated and gullible, and it can easily feel like the only way to get through that and be less likely to get hurt again is to get harder and stay hard.

But this is one of those "Oh, the humanity!" things for me. In the respect that I feel like yours is something you're dismissing or denying, not honoring and nurturing. Not only is that unlikely to keep you from getting hurt, it's more likely to keep you hurting like you are now for longer, and finding brand new ways to feel shitty.

I don't think trying to be tough about this, trying to make yourself feel or seem more coarse and callous when you're hurting a great deal, is going to serve you. I think it's going to make you ultimately hurt more, in a way that's harder to get through and resolve, and leave you with some sticky, black emotional residue and busted ways of thinking that will make only finding crummy people who aren't worthy of your love or trust a self-fulfilling prophecy.

That place? That super-tough, negative, any-feeling-but-snarky-anger-is-weak-and-stupid, this-group-of-people-are-just-all-lousy place? When we get hurt and angry, it's a place we may, and often do, visit. But it sounds to me like you might be trying to move in there for good, and between you and me, that is SUCH a crappy neighborhood. You do NOT want to live there. Make a pit stop if you must, but do not unpack your bag or get a lease: do what you must to get OUT of there and leave that place in the rearview.

It's not just important to get past that headspace because it takes a big toll on you now. I hear you expressing a desire to seek out relationships again, and I assume you want them to be good ones, where your trust isn't betrayed, and the people you're in them with treat you with care, love and respect and won't be inclined to behave badly. However, the real goodies we might be able to get involved with? That isn't who we're going to find while we have pitched our tent at Camp Bitter. If we start to try and pursue relationships -- or even just seek out interactions that are mostly only sexual and more casual -- when we're in a place like that, most or all of the only people who will want to be around us are crummy people, those who think poorly of themselves or others, and folks who will be jerks, because no one in their right mind is going to come to someone in that space with an open heart or with the idea that real care is on the menu (because it's not, just based on you when you're in that space). It wouldn't be safe or sound to, it would be emotionally suicidal or masochistic. There's no way to have interactions or relationships of real quality and depth with anyone when we're in that kind of space. And if you dig in there instead of passing through, I can almost promise you that all the lousy, bad stuff you're saying right now you're sure is in the cards for you will be, but mostly because of you.

It's just you and me here in this exchange right now, and when you're alone, it's just you. You should be able to be real with and for yourself, and to get over a loss like this, we have to be. We need to be able to own and honor when we are hurting like hell and let ourselves hurt like hell; we need to be able to allow and experience all the feelings we are having with something like this so we can get through to the other side and come out whole. Maybe you're still feeling too vulnerable to let down your guard around other people right now, and share how much this hurts: okay. But at the very least, I'd strongly suggest you let yourself, with and by yourself, feel however you feel and try to let go of your judgments about it, or attempts to toughen up when, I suspect, tough is probably the last thing you are feeling.

If you need it from someone, and can't give it to yourself yet, this is me, right now, giving you all the permission in the world to feel all of the things that you are and have been feeling about this, and to take whatever time you feel you need to mourn this. You get to be heartbroken. You get to be sad and to mourn. You get to be angry -- at your ex, at yourself if you've any of that, at the situation, what have you. In fact, my sense is that when people start getting angry at whole groups of people for what one has done, it's because their feelings are so big, they feel like they have to go on more than one person. Listening to you here, I hear a LOT of anger to deal with: and that's hardly surprising. It sounds like you've got a lot to be mad about. But really let it out so you can let it go, rather than trying to internalize it and make a new you out of it that even you probably won't like, love or want to treat well.

Since you wrote expressly to me, I assume you have some regard for me. So, if it helps, as a woman I'm guessing you don't think is stupid, I've mourned over people of all genders, including men, and including men who treated me badly. I've mourned over the loss of relationships that were big deals, and I've also mourned over the loss of relationships where I didn't even get why I was mourning, because they didn't seem like they were big deals at all. Perhaps that might help you realize women can grieve like this and not be stupid. Hell, maybe you now just think I'm stupid, too. In that case, how about you go ahead and be what you consider to be stupid knowing you've got some good company in that?

You get to be and feel all the things you're feeling. At the risk of sounding like a Hallmark card, I think none of your feelings can be stupid, bad or wrong because they are your feelings: they're all right and okay simply because you are feeling them. Perhaps more to the point, I don't know how there can ever be anything stupid or pathetic about honoring and experiencing our feelings, because that's the way we actually fully live and experience life, and also how we take good care of ourselves. And in the world we all live in, especially the hardest parts of being in it? Really owning and feeling our most painful feelings can take real courage. I don't think that kind of bravery is stupid or pathetic: I think it's courageous and laudable.

You're about to make some fresh starts, which sound to me like just the thing for you right now, so that's great timing. I suggest you do the same when it comes to letting yourself really feel and own all of these feelings, and working to let go of the yuck, and use these fresh starts to help you do that. I think it would feel a lot less invigorating to make the fresh starts you are if you bring all this baggage with you. You can't leave this experience completely behind, nor your feelings about it, but I think you can probably leave a good deal of the nasty goo it sounds like it's left on you, rather than working harder to keep it with you. Yay for fresh starts! Especially when you're walking out of the ashes. I'm excited for you.


For sure, starting to pursue dating, sex and relationships after a first-love/lust/sex/whatever might feel daunting, including having to learn to deal with parts of that differently than you did in your last relationship.

I feel it's best for you to take some more time first -- at least a few months, if not longer, especially if on top of still being in the thick of these feelings, this is a very recent breakup -- for yourself, to work through these feelings, get near or on the other side of them, and also get grounded in this new life first, before seeking out new partners. Like I said, the space you're in right now just isn't one where even the most casual of sexual interactions is likely to go at all well, or where you're likely to draw anything but other people feeling like you are right now to you.

But when you are more ready, managing things like new possible STI risks, and safer sex, including testing, isn't usually that hard or tricky, I promise.

There isn't such a thing as a "generic" STI test. There are tests for STIs specific to those specific infections, parasites or bacteria. We can get tested for only one, and we can get tested for more than one. If and when we want to get tested for all we can be tested for, we will ask for a full panel of STI tests, which generally will involve getting tested for all the STIs we can currently be tested for reliably. And yes, as with anything else where you're getting more than one thing versus one thing, the more tests you request, the more they will usually cost.

I think what you may be talking about is whatever basic group of tests a given clinic or practice tends to offer as a standard to patients who don't ask more specifically for tests. Ultimately, choices with testing involve working with a healthcare provider, with whom we share our sexual history, to determine what tests we need. They'll work with us to figure out what we have or haven't likely been exposed to, and also to figure out if and when we need or may want advanced testing we might not get otherwise, like, for example, a digene test for HPV rather than a pap smear (which doesn't test for HPV, but which can find cervical cell changes that often occur with HPV), an ELISA HIV test rather than only a rapid test, or a blood test for Herpes viruses versus only a visual exam or cell culture.

And truly: when you find a good sexual healthcare provider, you can trust them to work this out with you and make sound choices with what you need and what you don't. However, if you have great healthcare or a big wad of cash, and do just want to get every test possible, you can certainly ask for every test and have all those tests done.

As I explain here, testing for Herpes can be tricky, because it's so common that almost everyone has been exposed, and more people have it than those who don't, even though everyone doesn't have Herpes. Testing for Herpes is much more accurate when someone has an outbreak, which is one reason why most providers don't test for it otherwise. While there are some blood tests for HSV, the most reliable kinds of testing for HSV without outbreaks are costly and are not widely available, so you're not likely to see them used much, especially in public healthcare. It's not uncommon for a doctor or clinic not to use the most widely available blood tests for HSV because that kind of testing is known to often be unreliable. But this is certainly a conversation you can have -- and since you've questions about it, should have -- with an individual healthcare provider to get their assessment of what herpes tests you may or may not need, and to get their rationale on what they advise.

No matter what, if you want to protect yourself from STIs in the very best ways you can, that's going to mean using barriers -- like condoms or dental dams -- for at least any vaginal, oral or anal sex with someone else. Whether or not they have been tested, with a new or non-exclusive partner -- someone you have been a sexual partner with for less than at least six months, and where one or both of you aren't or haven't been sexually exclusive for all of those six months -- using those barriers is a must for effectively reducing your risks. If you later want to ditch any or all of those barriers, or for any or all of those activities, then the only way to do that where we know people can do so with a low STI risk is if they do only after that minimum exclusive-for-six-months-WITH-barriers, and then also AFTER a new round of testing for each partner at the end of that period of time. If then, for everything all of you can be tested for (which is most things, save one biggie, which is that men can't yet be tested for HPV), each of you has negative results, and each of you remains exclusive, then if you ditch barriers you can do so with a low risk of STIs.

It sounds like maybe what you will want to do is only engage in sex after or when someone has already been tested: and that's fine, we can absolutely have and set that limit and criteria for partners. But, if you want to be able to trust them around that, then just like trusting them with anything else, you're going to have to get to know them pretty well and build that trust first. So, your best bet to go that route is going to be to take relationships very slowly, and hold off on sex in them for a while until you've built the kind of trust where you do feel able to take someone largely at their word about testing. Taking time like that, too, will generally mean that if you want to ask someone to share the specifics of their tests and results with you, that asking for that is much more likely to result in a better reception you might get otherwise. After all, detailed personal health information -- especially things like testing results on paper -- is information many people just aren't comfortable sharing with someone they don't know very well.

Maybe you'll want to get sexual with someone before you've built up that kind of time an trust. If so, on top of again, using barriers, since we know that is the BEST way to reduce risks if we're going to choose to engage in sex with anyone, you can simply ask someone about testing, when they were last tested, for what infections, and where. Honestly, if someone says they get tested but can't answer those questions easily (save the part where sometimes people aren't sure of exactly what tests they were given), you can be pretty sure they're not being truthful. If they do answer them easily and quickly, I'd say you can be pretty sure they are being truthful.

If you ask someone and they haven't yet been tested, but having been tested is a sexual dealbreaker for you, you can just tell that person that you only sleep with people who have been tested recently. So, if they want to engage in sex with you, they'll need to do that first. I'd say the more plain and relaxed you can be about stating a limit like that, the better. When you're clear but chill about it, then they know they get to choose -- including that they can just opt out of sex with you if they don't want to be tested, probably feeling like you both can part that situation with a minimum of drama or fuss -- and that if they want to choose to have sex with you, that that will mean putting sex on hold for a bit until they get that testing done. And if it is something they really want to do, and they're someone with the maturity and care to respect people's limits and boundaries, all of which I'd assume you want with sexual partners anyway, then they'll probably be pretty chill about that, too.

(This doesn't have to be about "putting on a face," the way, like you mentioned: hopefully, you'll be done with posturing like that if and when you start engaging in sex with someone again, and can just be earnest with them. Since that's what it's clear you want from someone else, this is another one of those things where what you bring to the table is going to have a lot to do with what someone else does. So, if you play it like a game? They probably will, too. If you're clear, kind and real about it, and communicate with them like we do between mature, consenting adults with some semblance of humanity, they're more likely to do the same. While I'm pretty sure Ghandhi didn't intend his words to be used as safer sex advice, I do think "Be the change that you want to see," applies well here.)

You also want to make sure you're walking this walk yourself. After all, you've now had a previous partner, too, so before you ask anyone else to get tested, make sure that's a habit you've already started for yourself. Not only is that important per your health -- especially since you also had a partner who, for all we know, maybe wasn't exclusive with you before just recently -- it also makes asking someone else about testing land a whole lot better than when you're asking them about doing something you don't even do for yourself.

How do you get someone to get tested for you? I'd say you don't. This really isn't about getting tested "for you," even if, for a given person, one reason they might be choosing to get tested is because someone they want to be sexual with -- you -- has a limit around that that involves only sleeping with partners who get tested.

Sexual healthcare is something we all ultimately do, and need to do, for ourselves, even though it certainly benefits our sexual partners. If someone doesn't want to do that for themselves at least as much as they want to do it to get into bed with you, or want to do it because it's something you want, my personal advice is to nix on that partner and instead choose partners who are already ready to take care of themselves sexually, and including getting tested. I'd say when you're at an age it sounds like you are, my best advice is to choose partners who are already far enough along in managing their sexual lives like grownups that testing is something they already do, all by and for themselves, with no need for big nudging by sexual partners.

What media says about young people, sex and relationships is often not a sound reflection of the broader realities of young people, or any people, for that matter. It can also get a bit chicken-and-egg, where some people figure the media must be telling it like it is, so they adjust their wants and their behaviors to match it, and then what it says does actually start to become more reflective of realities. Since most media has an agenda -- one that's most often about just making money -- and is more about writing stories to get people to read than about accuracy, especially when it comes to sex and sexuality, I'd say going by what it says or suggests, rather than both what you observe in real life and truly want for yourself, isn't a smart or sound thing to do.

I'd go back to what you already observed among your peers, in your actual life experience, to find a better reflection of reality. I'd also remember that while your reality feels very changed right now due to what has just happened, this breakup hasn't actually changed the whole world. One ex who behaves badly can feel like it changes reality completely, but it can't really do that. The way this one person behaved doesn't mean your previous observations now aren't valid. The way this person behaved also is only a reflection of this one person: it doesn't tell you anything sound about all other men -- or any men besides this dude -- and it doesn't make whatever it is you want and need in future relationships impossible or out of reach.

Young people -- including young men -- still do engage in and want long-term relationships, just like you noticed. Some people, of any age, don't want long-term, exclusive relationships, period, or for certain periods of time or phases of life; some people are or do engage in more casual sex, sometimes or all the time. But that's some, not an all. The range of what people want in sexual and/or romantic relationships, and the range of human behavior in those relationships or interactions is vast. No one or no large group of people all want any one thing or model, or sexually behave in any one way.

If it turns out you still want a committed relationship, at this age or any other, you can still seek that out and likely will find those relationships. What kind of relationship you have or can have isn't up to the media, nor is most media -- and clearly, the kind you've been reading, which obviously isn't reflecting sound data or the range of realities around these things that we know exist in the world -- the expert on that. It also isn't about or dictated by what just happened with this relationship. It's up to you and the people you choose to pursue relationships with, when and if you do choose to pursue those kinds of relationships again.

It sounds to me like that's still what you ultimately want, and will probably come back to after you work through the heartbreak you're feeling around this breakup, really get back on your own two feet, remember and find out who you are now and what you want as the person you are outside that last relationship, and get back to seeing the world through a mind and a heart that isn't in so much pain.

I'm going to leave you with a few links to help with both learning about safer sex and negotiating it, and a couple to address building healthy relationships and love. I really hope the next few months or more can be a time of full emotional processing and self-care, one that provides you all the the excitement and invigoration of fresh starts, and that soon enough, you're feeling a whole lot better.

written 05 Mar 2013 . updated 13 Jan 2014

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